Employer Relief Act of 2018

H.R. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $90,632 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

H.R. 25 - The Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports H.R. 33 - Small Business Regulatory Flexibility Improvements Act This bill modifies the rulemaking requirements and procedures of federal agencies (excluding Congress, U.S. courts, U.S. territories and possessions, and the District of Columbia) under the Regulatory Flexibility Act of 1980 (RFA) and the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA). NSBA supports. H.R. 76 - Separation of Powers Restoration Act of 2017 This bill modifies the scope of judicial review of agency actions to authorize courts reviewing agency actions to decide de novo (without giving deference to the agency's interpretation) all relevant questions of law, including the interpretation of: (1) constitutional and statutory provisions, and (2) rules made by agencies. NSBA supports. H.R. 88 -- Retirement, Savings, and Other Tax Relief Act of 2018 and Taxpayer First Act of 2018 H.R. 88 would make a variety of changes to the tax code. Division A of the bill would extend many tax provisions that expired at the end of 2017 and provide tax relief for victims of disasters. The bill would also modify the requirements for tax-favored savings accounts and employer-provided retirement plans, change the deduction for start-up and organizational expenditures, make technical corrections to Public Law 115-97, and eliminate the increase in unrelated business taxable income related to certain transportation fringe benefits. Division B of the bill would make numerous changes to rules governing the Internal Revenue Service (IRS). NSBA supports. H.R. 198 -- Death Tax Repeal Act of 2017 This bill repeals the federal estate, gift, and generation-skipping transfer taxes. NSBA supports. H.R. 561 - Small Business Job Protection Act of 2017 This bill amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act, to redefine "applicable large employer," for purposes of the mandate requiring employers to provide health insurance for their employees, to mean an employer with at least 100 full-time employees (currently, 50). NSBA supports. H.R. 631 - Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill provides for an inflation adjustment to such exemption amount. NSBA supports. H.R. 1105 - Stop WOTUS Act To repeal the rule entitled "Clean Water Rule: Definition of 'Waters of the United States. NSBA supports H.R. 1314 - Renewable Fuel Standard Repeal Act The bill would remove the renewable fuel standard. NSBA is monitoring. H.R. 1339 - Freedom from Government Competition Act Legislation that would require federal agencies to rely on the private sector when providing goods and services that are readily available. NSBA supports. H.R. 1773 - The Clarity for Americas Small Contractors Act of 2017 Amends the Small Business Act to improve reporting on small business goals, achieve uniformity in procurement terminology, clarify the role of small business advocates, and for other purposes. NSBA supports. H.R. 1774 - The Developing the Next Generation of Small Business Act of 2017 Amends the Small Business Act to provide for improvements to small business development centers, the women's business center program, the SCORE program, and for other purposes. NSBA supports. H.R. 3170 - Small Business Development Center Cyber Training Act This bill amends the Small Business Act to require the Small Business Administration to establish a program for certifying employees of small business development centers to provide cybersecurity planning assistance to small businesses. NSBA supports. H.R. 3717 - the Small Business Owners Tax Simplification Act H.R 3717 introduces a number of provisions to benefit small businesses, such as aligning estimated payment deadlines and tax filing thresholds, as well as tackling inconsistencies in reporting requirements. NSBA supports. H.R. 3798 -- Save American Workers Act It delays the ACAs employer mandate, further postpones the so-called Cadillac tax on high-cost health plans and changes the definition of a full-time worker to someone employed 40 hours a week, up from 30 hours. In a win for the sun-tanning lobby, it would repeal ACAs 10 percent tax on indoor tanning salons. NSBA supports. H.R. 4111 - Spurring Business in Communities Act This bill amends the Small Business Investment Act of 1958 to: require the Small Business Administration (SBA), in reviewing and processing a small business investment company's (SBIC's) application, to give first priority to an SBIC applicant located in an underlicensed state (i.e., a state in which the number of licensees per capita is less than the median number of licensees per capita for all states) with below median financing; and exempt applicants in underlicensed states from certain SBA capital requirements. NSBA supports. H.R. 4616 - Employer Relief Act of 2018 It provide for a temporary moratorium on the employer mandate until Jan. 1, 2019 and delay for one year- until after Dec. 31, 2020-the implementation of the Cadillac Tax. NSBA supports. H.R. 4754 - Change Order Transparency for Federal Contractors Act Amend the Small Business Act to provide prospective construction contractors with information about an agency's policies on the administration of change orders to allow such contractors to make informed business decisions regarding the pricing of bids or proposals, and for other purposes. NSBA supports. H.R. 4886 - Permanent Tax Cuts for Americans Act This bill makes permanent the provisions of subtitle A (Individual Tax Reform) and subtitle B (Alternative Minimum Tax) of P.L. 115-97 (commonly known as the Tax Cuts and Jobs Act) that are currently scheduled to terminate on December 31, 2025. NSBA supports. H.R. 5236 - Main Street Employee Ownership Act Expands opportunities available to employee-owned business concerns through Small Business Administration loan programs, and for other purposes. NSBA supports. H.R. 5340 - Support Technology & Research for Our Nations Growth and Economic Resilience (STRONGER) Patents Act The STRONGER Patents Act would restore patents as property rights, make standards of protections in courts uniform, and protect start-ups from being out-resourced by technology incumbents. NSBA supports. H.R. 5660 - The Small Business Credit Card Act The measure provides small-business owners the same consumer protections as individual credit card holders, by protecting small-business owners credit cards from unfair and deceptive practices of credit card companies. NSBA supports. H.R. 5728 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. H.R. 6199 -- Restoring Access to Medication Act of 2018 This bill repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, health flexible spending arrangements, and health reimbursement arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). The bill also allows the accounts to be used for menstrual care products. NSBA supports. H.R. 6264 - Restoring Americas Leadership in Innovation Act Bill offers various reforms and other improvements to the current U.S. patent system and helps to reverse prior bills discouraging innovation in the U.S. by weakening patents. NSBA supports. H.R. 6301 - Promoting High-Value Health Care through Flexibility for High Deductible Health Plans Act of 2018 It expands access and enhances the utility of HSAs by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible. NSBA supports. H.R. 6305 - Bipartisan HSA Improvement Act of 2018 The bill would allow eligible individuals to make HSA contributions if a spouse has a flexible spending account and permit flexible spending accounts and health reimbursement account terminations or conversions to fund HSAs. NSBA supports. H.R. 6306 - Health Care Security Act of 2018 It expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA. NSBA supports. H.R. 6311 - The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act The bill expands access and use of Health Savings Accounts (HSAs) and lowers premiums on health care plans. NSBA supports. H.R. 6314 - Health Savings Act of 2018 H.R. 6314 expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions. NSBA supports. H.R. 6316 - Small Business Advocacy Improvements Act of 2018 H.R. 6316 allows the SBA Office of Advocacy to examine the role of small business in international economies and to represent small business views before foreign governments and international entities. NSBA supports. H.R. 6321 - Investment Adviser Regulatory Flexibility Improvement Act The legislation directs the SEC to consider alternative methods for businesses or organizations to qualify as a small business or small organization for the purposes of assessing the regulatory impact on investment advisors. NSBA supports. H.R. 6330 - Small Business Runway Extension Act of 2018 H.R. 6330 modifies SBAs size calculation to provide small businesses with more time to be considered small for the purposes of SBAs small business programs. NSBA supports. H.R. 6347 - 7 (a) Real Estate Harmonization Act H.R. 6347 updates SBAs 7(a) Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6348 - Small Business Access to Capital and Efficiency (ACE) Act H.R. 6348 reduces burdens and conflicting regulations for small businesses by updating the Small Business Administrations 504/Certified Development Company Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6367 - Incentivizing Fairness in Subcontracting H.R. 6367 allows large prime contractors to take credit for subcontracting to small businesses at lower tiers, provided that prime contractors keep records substantiating subcontracting credit claimed at lower tiers, and creates a new dispute process for small subcontractors to bring nonpayment issues to the agencys small business advocate (Offices of Small and Disadvantaged Business Utilization). NSBA supports. H.R. 6368 - Encouraging Small Business Innovators Act H.R. 6368 makes a series of changes to the Small Business Innovation Research and Small Business Technology Transfer programs, making them easier for small firms to use. NSBA supports. H.R. 6369 - Expanding Contracting Opportunities for Small Businesses Act of 2018 H.R. 6369 increases the size of sole source contract awards for women owned, service-disabled veteran-owned, HUBZone, and socially and economically disadvantaged small businesses, and implements a new eligibility determination process to ensure sole source awards are made to eligible firms. NSBA supports. H.R. 6382 -Clarity on Small Business Participation in Category Management Act of 2018 H.R. 6382 requires the SBA to report federal spending made through designated best-in-class vehicles, and to report on the dollars spent through these vehicles awarded to small businesses. NSBA supports. H.R. 6446 - White House Conference on Small Business Act of 2018 It reauthorizes, and amends, the White House Conference on Small Business Authorization Act from the early 1990s, which is Public Law 101-409. The bill requires the state conferences, regional conferences and the National Conference to occur no earlier than December 31, 2018 and no later than December 1, 2019. NSBA supports. H.R. 6695 -The Trademark Licensing Protection Act of 2018 The bill clarifies that licensing trademarks, and controlling or exercising those trademarks, do not create an employment relationship. NSBA is monitoring. H.R. 6757 - The Family Savings Act of 2018 It includes a variety of provisions aimed at making it easier for smaller businesses to offer tax-qualified retirement savings plans to their employees, encouraging individuals to participate in retirement plans, and promoting savings for nonretirement expenses. NSBA is monitoring. H.R. 6756 - The American Innovation Act of 2018 It includes two provisions intended to boost innovation by allowing new businesses to write off larger amounts of their costs up front as well as allowing a corporation that buys a start-up to retain some of the acquired entitys net operating losses or other tax attributes, like research and development tax credits. NSBA supports. H.R. 6760 - the Protecting Family and Small Business Tax Cuts Act of 2018 Bill would make permanent provisions from the 2017 tax law such as the lower individual income tax rates, the higher standard deduction, the increased and modified child tax credit, the increased exemption and phase-out threshold for the individual alternative minimum tax, the increased estate and gift tax exemption, and the 20 percent deduction for certain pass-through income, all of which are currently set to expire after 2025. NSBA supports. S. 18 - the Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports S. 21 - Regulations from the Executive in Need of Scrutiny (REINS) Act The REINS Act seeks to restore authority to Congress by allowing lawmakers to have final say on regulations with an estimated economic impact of more than $100 million. NSBA supports. S. 34 - Midnight Rule Relief Act The bill would prevent agencies from proposing or finalizing regulations from the day after elections to the day of the next presidential inauguration. NSBA supports S. 205 -- Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill also provides for an inflation adjustment to such exemption amount. NSBA supports. S. 584 - The Small Business Regulatory Flexibility Improvements Act To require federal agencies to analyze the full impact of a proposed regulation on small businesses during the rulemaking process. NSBA supports. S.791 - Small Business Innovation Protection Act of 2017 To amend the Small Business Act to expand intellectual property education and training for small businesses, and for other purposes. NSBA supports. S. 951 - the Regulatory Accountability Act (RAA) This bill codifies and revises notice-and-comment rulemaking procedures to require federal agencies to consider: (1) whether a rulemaking is required by statute or is within the discretion of the agency, (2) whether existing federal laws or rules could be amended or rescinded to address the problem, and (3) reasonable alternatives for a new rule. NSBA supports. S.1390 - STRONGER Patents Act of 2017 The STRONGER Patents Act takes critical steps to improve the patent system. It treats patents like any other property, permitting injunctions to protect patent owners against infringement during and after court cases. It ensures fairness in Patent Office administrative proceedings, limiting repetitive and harassing challenges against inventors and it ends the diversion of patent application fees to other government spending, ensuring the Patent Office has the funding needed to grant high-quality patents without harmful delay. NSBA supports. S.2108 - The Miscellaneous Tariff Bill Act of 2017 Trims the duties on more than 1,800 imports deemed to not pose a competitive threat to U.S. producers. NSBA supports. S.2283 - The Small Business 7(a) Lending Oversight Reform Act of 2018 Amends the Small Business Act to strengthen the Office of Credit Risk Management within the Small Business Administration, and for other purposes. NSBA supports. S.2708 - Choose Medicare Act Bill creates a Medicare health plan for all ages that would be offered in state and federal health exchanges, as well as the employer-sponsored market. NSBA is monitoring. S. 2800 - Americas Water Infrastructure Act of 2018 A bill to provide for the conservation and development of water and related resources, to authorize the Secretary of the Army to construct various projects for improvements to rivers and harbors of the United States, and for other purposes. NSBA supports. S. 2810 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. S. 3345 - Economic Security for New Parents Act Bill allows those who choose to withdraw from their Social Security benefits early will be able to get at least two months of leave after the arrival of a child by birth or adoption. NSBA is monitoring.

Client expense: $27,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Export-Import Bank of the United States (EXIM Bank), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Intl Trade Administration (ITA), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Personnel Management (OPM), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 4616, A bill to amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage - Cadillac Tax and Employer Mandate Moratorium

Client expense: $430,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

H.R. 4616, A bill to amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage - Cadillac Tax and Employer Mandate Moratorium

Client expense: $480,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

H.R. 35 / S. 403 - Health Savings Act of 2017. Support for H.R. 4616 - To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high-cost employer-sponsored health coverage. Support for H.R. 3798 - Save American Workers Act of 2018.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4616, A bill to amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage - Cadillac Tax and Employer Mandate Moratorium H.R. 6306, A bill To amend the Internal Revenue Code of 1986 to increase the contribution limitation for health savings accounts, and for other purposes - HSA legislation

Client expense: $330,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act, and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), H.R. 6, the SUPPORT for Patients and Communities Act, and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans. 21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), H.R. 6, the SUPPORT for Patients and Communities Act and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans. 21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability.

Client expense: $2,360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office

House Bills H.R. 6760, Protecting Family and Small Business Tax Cuts of 2018 - Support H.R. 6311, Increasing Access to Lower Premiums Plans and Expanding Health Savings Account Act of 2018 - Support H.R. 50, Unfunded Mandates Information and Transparency Act of 2018 - Support H.R. 4616, Employer Relief Act of 2018 - Support H.R. 1150, Tanning Tax Repeal Act of 2017 - Support H.R. 5948, Small Carrier Electronic Logging Device Exemption Act of 2018 - Support H.R. 4229, Protecting HOME Access Act of 2017 - Support H.R. 3798, Save American Workers Act - Support H.R. 50, the Unfunded Mandates Information and Transparency Act of 2017 - Support H.R. 6277, Main Street Tax Certainty Act - Support Senate Bills PN 2259, Nomination of Brett M. Kavanaugh - Support S.J. Res 63, Congressional resolution of disapproval of the rule expanding short-term, limited duration health insurance plans - Support S. 2687, A bill to amend the Internal Revenue Code of 1986 to make permanent the individual tax provisions of the tax reform law - Support Testimony Courtney Titus Brooks, NFIB, hearing on Internal Revenue Service Notice of Proposed Rulemaking Titled Qualified Business Income Deduction, REG-107892-18, 83 Fed. Reg. 40884. October 16, 2018. Comments Comments in Response to Departments of the Treasury, Labor, and Health and Human Services Notice of Proposed Rulemaking Titled, Health Reimbursement Arrangements and Other Account-Based Group Health Plans, REG-136724-17, 83 Fed. Reg. 54420 (October 29, 2018). Comments on Internal Revenue Service Notice of Proposed Rulemaking titled Qualified Business Income Deduction, REG-107892-18, 83 Fed. Reg. 40884 (August 16, 2018). Other Issues: Health Insurance Tax (HIT) Project Labor Agreements (PLAs) Nomination to the National Labor Relations Board (NLRB) Tax treatment of capital gains

Client expense: $1,110,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), Treasury, Dept of

H.R. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $90,632 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

Patient Protection and Affordable Care Act (P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152); ACA reporting requirements; ERISA; tax treatment of employer-sponsored health coverage; employer-sponsored wellness programs; H.R. 173/S. 58 - ACA 40 percent excise tax repeal; H.R. 394/S. 85 - consumer directed health products/over-the-counter; H.R. 246 - HIT repeal; H.R. 1628 (FY17 reconciliation); COBRA; H.R. 3919/S. 1908 - Commonsense Reporting Act; HR 5138 - Bipartisan HSA Improvement Act; H.R. 6 - SUPPORT for Patients and Communities Act; H.R. 6301 - high deductible health plans with first dollar coverage; H.R. 6305 - Bipartisan HSA Improvement Act; H.R. 6312 - Personal Health Investment Today (PHIT) Act; H.R. 6199 - Restoring Access to Medication and Modernizing Health Savings Accounts Act; H.R. 4616 - temporary moratorium on the employer mandate and to provide for a delay of 40-percent excise tax; H.R. 3798 - Save American Workers Act; H.R. 6311 - Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act.

Client expense: $710,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE), U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR), White House Office

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 88, Retirement, Savings, and Other Tax Relief Act - relief from health insurance tax and Cadillac tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act H.R. 35, Health Savings Act of 2017 H.R. 143, Health Insurance Industry Antitrust Enforcement Act of 2017 H.R. 173/S. 40/S. 58, Middle Class Health Benefits Tax Repeal Act of 2017 H.R. 184, Protect Medical Innovation Act of 2017 H.R. 195, Making further continuing appropriations for the fiscal year ending September 30, 2018, and for other purposes H.R. 246, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 394/S. 85, Restoring Access to Medication Act of 2017 H.R. 620, ADA Education and Reform Act of 2017 H.R. 849/S. 260, Protecting Seniors Access to Medicare Act H.R. 1101, Small Business Health Fairness Act of 2017 H.R. 1175/S. 403, Health Savings Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 1313, Preserving Employee Wellness Programs Act H.R. 1625, Consolidated Appropriations Act, 2018 H.R. 1892, Bipartisan Budget Act of 2018 H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology H.R. 3798, Save American Workers Act of 2017 H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2018 H.R. 4616, To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 4617, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on the medical device excise tax H.R. 4618, To amend the Internal Revenue Code of 1986 to provide for a temporary moratorium on certain taxes affecting purchases of prescription medication H.R. 4619, To amend the Patient Protection and Affordable Care Act to provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance H.R. 4620, Protecting Families and Small Businesses Act of 2017 H.R. 4978/S. 2410, Chronic Disease Management Act of 2018 H.R. 5009, Jessies Law H.R. 5041, Safe Disposal of Unused Medication Act H.R. 5138, Bipartisan HSA Improvement Act of 2018 H.R. 5272, To provide additional guidance to grantees seeking funding to treat or prevent mental health or substance use disorders H.R. 5582, Abuse Deterrent Access Act of 2018 H.R. 5788, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 H.R. 5892, To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 S. 108, Medical Device Access and Innovation Protection Act S. 191, Patient Freedom Act of 2017 S. 222, Obamacare Replacement Act S. 251, Protecting Medicare from Executive Action Act of 2017 S. 974, Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act of 2017 S. 1835, Lower Premiums Through Reinsurance Act of 2017 S. 1850, Protecting Jessica Grubb's Legacy Act S. 1859, Healthcare Tax Relief Act S. 1978, Small Business and Family Health Tax Relief Act of 2017 S. 2004, Combating the Opioid Epidemic Act S. 2164, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings S. 3057, Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018 Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years and provide meaningful State flexibility (Alexander-Murray) Proposed regulation on health reimbursement arrangements and other account-based group health plans (83 Fed. Reg. 54,420-54,477, October 29, 2018) Final Regulation, definition of employer under Section 3(5) of ERISA - association health plans (83 Fed. Reg. 28912-28964, June 21, 2018) Various issues relating to Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including the employer-sponsored health care system, implementation of regulatory process, provider network adequacy, delivery system reform, health savings account (HSAs), health reimbursement account (HRAs), and flexible spending account (FSAs) changes, IPAB, employer mandate, reporting requirements for issuers and applicable large employers, premium stabilization programs, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, section 1332 waivers, section 1557 on nondiscrimination, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analysis, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits, the Cost Sharing Reduction (CSR) program, the section 9010 Health Insurance Providers Fee or Health Insurance Tax (HIT), 40% excise tax on high-cost employer-sponsored health coverage (Cadillac tax); medical device tax; protect Medicare Part D's Non-Interference Clause from repeal Public Health Services Act (P.L.78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), regarding regulatory process and legislative corrections to ERISA preemption, changes to Medicare Advantage and Parts B, C, and D, including rebates and non-interference with prescription drug prices, entitlement reform, health information technology, telemedicine services in Medicare, and coordination and disease management programs; House Republican Taskforce on Health Care report; A Better Way to Fix Health Care; association health plans; importation of foreign pharmaceuticals into the United States and preemptive authority of federal food and drug regulations; Executive Order 13813, Promoting Healthcare Choice and Competition; addressing the opioids crisis, including end-stage renal disease; balance or surprise billing; single-payer health care options; aligning 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (P.L. 104-191) for the purposes of treatment, payment, and health car operation (TPO); inclusion of prescription drug pricing on 2019 congressional agenda; general advocacy for Congress to reach a working quorum for the board of the Export-Import Bank; section 301 of the Trade Act of 1974; U.N. Convention on the Assignment of Receivables in Int'l Trade

Client expense: $15,950,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Financial Protection Bureau (CFPB), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Energy Regulatory Commission (FERC), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Office of the Vice President of the United States, Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Social Security Administration (SSA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

Legislative Opioids Crisis Response Act - S. 2680/H.R. 6 Health Care Reform - ongoing legislative and regulatory implementation of the Patient Protection and Affordable Care Act (ACA), Cadillac tax on health benefits Continuing Appropriations Act of 2018 - H.J. Res. 125 - two year delay of the Cadillac Tax Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Health Savings Act of 2017 - S. 403/H.R. 1175 Creating High Quality-Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act - S. 870 Save American Workers Act - H.R. 3798 Chronic Disease Management Act of 2018 - S. 2410/H.R. 4978 Broader Options for Americans Act - H.R. 2579 Commonsense Reporting Act of 2017 - S. 1908/H.R. 3919 Workflex in the 21st Century Act - H.R. 4219 ACA Relief Legislation - H.R. 4616 Bipartisan HSA Improvements Act of 2018 - H.R. 5138 HSA Employer Flexibility Act - H.R. 6128 Restoring Access to Medication and Modernizing Health Savings Accounts Act - S. 6199 Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act - H.R. 6311 Patient Right to Know Drug Prices Act - S. 2554 Paid Family Leave Pilot Extension Act of 2018 - S. 3412 Reducing Costs for Out-of-Network Service Act of 2018 - S. 3541 No More Surprise Medical Bills Act of 2018 - S. 3592 Retirement, Savings, and Other Tax Relief Act of 2018 Protecting Patients from Surprise Medical Bills Act - Legislative Discussion Draft The Bipartisan Budget Act of 2018 Consolidated Appropriations Act of 2018 Fiscal Year 2019 budget proposal - provisions affecting employer-sponsored benefits Cost transparency and out-of-network billing Regulatory and Other Cost transparency Association Health Plans (AHPs) Health Reimbursement Accounts (HRAs) - Proposed regulations to use HRAs to purchase health insurance on the individual markets High Deductible Health Plans (HDHPs) Health Savings Accounts (HSAs) Department of Health & Human Services - Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs Federal disaster tax, filing and reporting relief for employers and individuals Presidential Executive Order: Reducing Regulation and Controlling Regulatory Cost Presidential Executive Order: Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States - STLDI Employer wellness programs - nondiscrimination rules: Americans with Disabilities ACT (ADA) & Genetic Information Nondiscrimination Act (GINA) - Final regulations Medicare Advantage Program State health care requirements affecting self-insured plans FAQs - proposed guidance regarding implementation the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) - as amended by the Affordable Care Act (ACA) and the 21st Century Cures Act Electronic communication and disclosure of benefits information Paid leave proposals and issues

Client expense: $286,066 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, White House Office

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Health care reform and tax reform issues related to the taxation of employer-provided health benefits, including the 40% tax on health benefits. Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 H.R. 4616, a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Health care reform and tax reform issues related to the taxation of employer-provided health benefits, including the 40% tax on health benefits. Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 H.R. 4616, a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage

Client expense: Not reported · Firm income: $40,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

H.R 4894, The Harmful Tax Prevention Act. Monitored the implementation of The Tax Cut and Jobs Act, P.L. 115-97, as it relates to corporate tax issues, the taxation of multinational corporations and life insurance; S.58 / H.R. 173, Middle Class Health Benefits Tax Repeal Act of 2017. H.R. 4620, Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. H.R. 4616, the Employer Relief Act, regarding a one-year delay of the Cadillac tax; H.R. 88, A bill to change the boundaries of Shiloh National Park in Tennessee and issues related to the HIT and Cadillac tax.

Client expense: Not reported · Firm income: $60,750

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 1 - Tax Cuts and Jobs Act (Reduces ACA individual mandate penalty.) H.R. 6 - Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (Employer-sponsored plan Medicare secondary payer rules.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 3798 - Save American Workers Act (Amends the ACA definition of full-time.) H.R. 5138 - Bipartisan HSA Improvement Act of 2018 (Expands the use of Health Savings Accounts.) H.R. 6128- HSA Employer Flexibility Act (Expansion of HSAs to include on-site employee clinics, retail clinics & telehealth services.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Repeals the health care excise tax.) H.R. 3919 and S. 1908 - Commonsense Reporting Act (Clarifies the ACA employer reporting requirements.) H.R. 4978 / S. 2410 - Chronic Disease Management Act of 2018 (Expands HSA to provide care for chronic conditions with no deductible.) H.R. 6301 - Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Expands the use of Health Savings Accounts.) H.R. 6305 - Bipartisan HSA Improvement Act (Expands the use of Health Savings Accounts.) H.R.6199 - Restoring Access to Medication Act (Expands the use of Flexible Spending Arrangements and Health Savings Accounts.) H.R. 6312- Personal Health Investment Today (PHIT) Act (Expands the use of Health Savings Accounts.) H.R. 4616 - Employer Relief Act (Repeals employer mandate penalty.) H.R. 6311 - Premium Plans and Expanding Health Savings Accounts Act (Expands the use of Health Savings Accounts.) H.J. Res 125 The Extension of Continuing Appropriations Act (Delayed the Cadillac Tax until 2022.) S. 1782 - Forty Hours is Full-Time Act (Amends the ACA definition of full-time.) Association Health Plans (DOL) Health Care Reform - White House ACA Employer Reporting Requirements - Treasury Department

Client expense: $445,840 · Firm income: Not reported

Government targets: Equal Employment Opportunity Commission (EEOC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), Treasury, Dept of, White House Office

The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.6261 - Improving Choices in Health Care Coverage Act S.3095 - Building a Health Care Workforce for the Future Act H.R.6128 - HSA Employer Flexibility Act H.R.6110 - Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018 H.R.6098 - Family Medical Leave Modernization Act H.R.6097 - State-Based Universal Health Care Act of 2018 H.R.6082 - Overdose Prevention and Patient Safety Act H.R.6 - SUPPORT for Patients and Communities Act S.3063 - Health Insurance Tax Relief Act of 2018 H.R.6071 - SERV Communities Act S.3053 - CHIP Mental Health and Addiction Parity Act S.3048 - Examining Opioid Treatment Infrastructure Act of 2018 H.R.6050 - Increasing Access to Care Act S.3016 - Action for Dental Health Act of 2018 S.3000 - Patient Advocacy Transparency Act H.R.5997 - Ensuring Patient Access to Critical Breakthrough Products Act of 2018 H.Res.915 - Expressing the sense of the Congress in support of protecting patients' access to medically appropriate, evidence-based healthcare and information, and the ethical and professional obligations of healthcare professionals to provide that care and information H.R.5966 - Women Veterans Access to Quality Care Act of 2018 H.R.5965 - Access to Infertility Treatment and Care Act H.R.5963 - To delay the reimposition of the annual fee on health insurance providers until after 2020 S.2960 - Access to Infertility Treatment and Care Act S.Res.526 - A resolution expressing the sense of the Senate that politicians should not interfere with a woman's personal health care decisions or attempt to prevent providers from offering their full medical recommendations to their patients H.R.5942 - Health Equity and Accountability Act of 2018 H.R.5933 - Substance Abuse Prevention Act of 2018 H.R.5932 - Increasing Access to Mental Health in Schools Act H.R.5925 - CRISIS Act S.2934 - Increasing Access to Mental Health in Schools Act H.R.5917 - Professional's Access to Health Workforce Integration Act of 2018 H.R.5914 - To require a study and report on policy and regulatory changes that may have contributed to the opioid epidemic S.2920 - Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act of 2018 S.2912 - Opioid Addiction Treatment Programs Enhancement Act H.R.6144 - Know the Lowest Price Act of 2018 S.204 - Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017 S.2680 - Opioid Crisis Response Act of 2018 H.R.5511 - Healthy Communities Act of 2018 H.R.5491 - Rural Health Insurance Act of 2018 H.R.5455 - Accelerating Biomedical Research Act H.R.5641 - State Offices of Rural Health Reauthorization Act of 2018 H.R.5625 - Easy Enrollment Act of 2018 H.R.5624 - Pathway to Universal Coverage Act of 2018 H.R.5603 - Access to Telehealth Services for Substance Use Disorders Act S.2732 - Defending Access to Mental Health Care Act H.R.5699 - HOST Act of 2018 S.2802 - Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2018 H.R.5725 - BEST Act S.2902 - Better Data Sharing to Combat the Opioid Crisis Act S.2901 - eTREAT Act H.R.5892 - To establish an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address the impact of opioid abuse on the workplace H.R.5858 - Primary Care Patient Protection Act of 2018 S.2875 - COMBAT Act of 2018 H.R.5795 - Overdose Prevention and Patient Safety Act S.2851 - Regional Health Care Emergency Preparedness and Response Systems Act H.R.5775 - Providing Reliable Options for Patients and Educational Resources Act of 2018 H.R.5769 - Expanding Access to Treatment Act S. 2608 - Reducing Opioid Risk Act S. 2589 - Comprehensive Opioid Recovery Centers Act of 2018 S. 2582 - Consumer Health Insurance Protection Act of 2018 S. 2554 - Patient Right to Know Drug Prices Act H.R. 5258 - Affordable Health Insurance for the Middle Class Act H.R. 5254 - To direct the Secretary of HHS to conduct a study on the feasibility of expanding eligibility for enrollment in Medicare Advantage plans to individuals enrolled under the Medicaid program or enrolled under a group health plan H.R. 5223 - Health Care Workplace Violence Prevention Act S. 2507 - Improving Choice in Health Care Coverage Act H.R. 5155 - Undo Sabotage and Expand Affordability of Health Insurance Act of 2018 S. 2496 - Small Business Health Account Act of 2018 S. 2494 - Fair Care Act H.R. 5138 - Bipartisan HSA Improvement Act of 2018 H.R. 5124 - Community Action Opioid Response Act of 2018 H.R. 5097 - PAVE Act of 2018 H.R. 5080 - COMBAT Act of 2018 H.R. 5062 - Advancing Access to Precision Medicine Act H.R. 5047 - VA Community Care Enhancement Act S. 2437 - Opioid Response Enhancement Act S. 2415 - Accelerating Kids Access to Care Act H.R. 4978 - Chronic Disease Management Act of 2018 S. 2410 - Chronic Disease Management Act of 2018 H.R. 4952 - To direct the Secretary of HHS to conduct a study and submit a report on the effects of the inclusion of quality increases in the determination of blended benchmark amounts under part C of the Medicare program H.R. 4938 - Respond NOW Act H.R. 4894 - Harmful Tax Prevention Act H.R. 4841 - Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 H.R. 4831 - Healthcare Tax Relief Act H.R. 4820 - ASK Act S. 2315 - Over-the-Counter Drug Safety, Innovation, and Reform Act H.R. 4808 - Transparent Health Care Pricing Act of 2018 S. 2312 - HELP Act H.R. 4784 - ACA OUTREACH Act H.R. 4778 - Behavioral Health Coverage Transparency Act of 2018 S. 2302 - Access to Independent Health Insurance Advisors Act of 2018 S. 2301 - Behavioral Health Coverage Transparency Act of 2018 H.R. 4575 - A bill to amend title XXVII of the Public Health Service Act to preserve consumer and employer access to licensed independent insurance producers. S. 2303 - A bill to amend title XXVII of the Public Health Service Act to preserve consumer and employer access to licensed independent insurance producers. H.R. 1625 - Consolidated Appropriations Act, 2018 S. 2553 - Know the Lowest Price Act of 2018 H.R. 5343 - Prescription Transparency Act of 2018 H.R. 5150 - Protecting Medicare from Excessive Price Increases Act of 2018 H.R. 4874 - End The Shutdown Act of 2018 H.R. 4872 - End The Shutdown Act of 2018 H.R. 5104 - A bill to amend title XVIII of the Social Security Act to provide for a special enrollment period under Medicare for individuals enrolled in COBRA continuation coverage, and for other purposes H.R. 6 - SUPPORT for Patients and Communities Act S. 2554 - Patient Right to Know Drug Prices Act S. 2553 - Know the Lowest Price Act of 2018 H.R. 302 - FAA Re authorization Act of 2018 H. R. 6662 - Empowering Seniors Enrollment Decision Act of 2018 H.R. 6305 - Bipartisan HSA Improvement Act of 2018 H.R. 6312 - Personal Health Investment Today (PHIT) Act H.R. 6309 - To amend the Internal Revenue Code of 1986 to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 4616 - To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6311 - To amend the Internal Revenue Code of 1986 and the Patient Protection and Affordable Care Act to modify the definition of qualified health plan for purposes of the health insurance premium tax credit and to allow individuals purchasing health insurance in the individual market to purchase a lower premium copper plan

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R.6199 - To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses H.R. 4894 - Harmful Tax Prevention Act H.R. 4831 - Healthcare Tax Relief Act H.R. 6305 - Bipartisan HSA Improvement Act of 2018 H.R. 6312 - Personal Health Investment Today (PHIT) Act H.R. 4616 - To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6311 - To amend the Internal Revenue Code of 1986 and the Patient Protection and Affordable Care Act to modify the definition of qualified health plan for purposes of the health insurance premium tax credit and to allow individuals purchasing health insurance in the individual market to purchase a lower premium copper plan.

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R. 4616, the Employer Relief Act of 2018 H.R. 1038/S. 413 - Improving Transparency and Accuracy in Medicare Part D Spending Act H.R.592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 1313 - The Preserving Employee Wellness Programs Act H.R. 3919/S. 1908 - Commonsense Reporting Act of 2017 H.R. 3798 - Save American Workers Act of 2017 H.R. 6199 - To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses HIT delay

Client expense: $160,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act, all provisions; HR1101 - Small Business Health Fairness Act, all provisions; HR173/S58 - Middle Class Health Benefits Tax Repeal Act, all provisions; H.R. 246 Jobs and Premium Protection Act; S.1859 - Healthcare Tax Relief Act; S.1978 - Small Business and Family Health Tax Relief Act; HR 4616 - Cadillac Tax; Employer Mandate Delay; H.R.4620 - Protecting Families and Small Businesses Act; HR4200/S.2052 - Healthcare Market Certainty and Mandate Relief Act; S. 1996/HR 2919 Commonsense Reporting Act; Cadillac Tax; ERISA; Opioids Legislation - mental health parity enforcement. HR 5138, Bipartisan HSA Improvement Act, all provisions. DOL rule on Association Health Plans; surprise billing. H.R.6 - Support for Patients and Communities Act, Mental health parity; ESRD HR 6301 - All Provisions HR 6317 - All Provisions HR 6305 - All Provisions, Bipartisan HSA Improvement Act HR 6312 - All Provisions, PHIT Act HR 6309 - All Provisions HR 6199 - All Provisions HR 6306 - All Provisions HR 6313 - All Provisions, Responsible Additions And Increases To Sustain Employee Health Benefits HR 6314 - All Provisions, Health Savings Act HR 6311 - All Provisions HR 3919 - All Provisions, Commonsense Reporting Act S.1908 - Commonsense Reporting Act H.R. 3798-Save American Workers Act - all provisions

Client expense: $2,540,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Commerce, Dept of (DOC), Consumer Financial Protection Bureau (CFPB), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Federal Maritime Commission, Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Labor Relations Board (NLRB), Natl Telecommunications & Information Administration (NTIA), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Customs & Border Protection, White House Office

Issues related to employer-sponsored coverage; Issues related to the Affordable Care Act and health reform; Issues related to the taxation of employer-sponsored coverage and ACA taxes; Issues related to consumer-directed health products, including H.R. 5138, H.R. 6199, H.R. 6311; Issues related to IRS reporting, including H.R. 3919, S. 1908; Issues to related to the ACA employer mandate, including H.R. 3798, S.1782, H.R. 3956, S. 2670, H.R. 4616; Issues related to association health plans; Issues related to drug costs.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, and H.R. 1628, the American Health Care Act of 2017 and the Better Care Reconciliation Act. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, regarding a one-year delay of the Cadillac Tax. H.R. 4620, regarding relief from the Health Insurance Tax. Senate motion to concur in the House amendment to the Senate amendment to H.R.195, CR/CHIP, with further amendment (includes: CR funding until February 8, 2018; 6 year CHIP; ACA tax delays).

Client expense: $1,890,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, State, Dept of (DOS), Treasury, Dept of

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, and H.R. 1628, the American Health Care Act of 2017, the Better Care Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, regarding a one-year delay of the Cadillac Tax. H.R. 4620, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically the Overdose Prevention and Patient Safety Act (OPPS Act). Issues related to H.R.1625, the Consolidated Appropriations Act of 2018.

Client expense: $1,890,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, State, Dept of (DOS), Treasury, Dept of

H.R.5 - Regulatory Accountability Act of 2017 To reform the process by which Federal agencies analyze and formulate new regulations and guidance documents, to clarify the nature of judicial review of agency interpretations, to ensure complete analysis of potential impacts on small entities of rules, and for other purposes. NSBA supports. H.R. 8 - Water Resources Development Act of 2018 H.R. 8 authorizes Army Corps of Engineers (Corps) civil works activities and builds on previous reform efforts to ensure improvements are made to the Nations ports, inland waterways, locks, dams, flood protection, ecosystem restoration, and other water resources infrastructure. NSBA supports. H.R. 10 - The Financial CHOICE Act of 2017 Bill repeals provisions of the Dodd-Frank Act, aims to eliminate red tape to increase access to capital and credit and create opportunities for investors, consumers and entrepreneurs. NSBA is monitoring. H.R. 25 - The Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports H.R. 33 - Small Business Regulatory Flexibility Improvements Act This bill modifies the rulemaking requirements and procedures of federal agencies (excluding Congress, U.S. courts, U.S. territories and possessions, and the District of Columbia) under the Regulatory Flexibility Act of 1980 (RFA) and the Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA). NSBA supports. H.R.76 - Separation of Powers Restoration Act of 2017 This bill modifies the scope of judicial review of agency actions to authorize courts reviewing agency actions to decide de novo (without giving deference to the agency's interpretation) all relevant questions of law, including the interpretation of: (1) constitutional and statutory provisions, and (2) rules made by agencies. NSBA supports. H.R. 79 - Helping Angels Lead Our Startups (HALOS) Act The legislation will make it easier for businesses to notify potential investors of their offerings as well as provide a statutory definition for angel investor group. Additionally, it would require the Securities Exchange Commission (SEC) to revise the Regulation D rules regarding general solicitation. NSBA supports. H.R. 184 -- Protect Medical Innovation Act of 2017 This bill amends the Internal Revenue Code to repeal the excise tax on the sale of a medical device by the manufacturer, producer, or importer. NSBA supports. H.R. 198 -- Death Tax Repeal Act of 2017 This bill repeals the federal estate, gift, and generation-skipping transfer taxes. NSBA supports. H.R. 477 - Small Business Mergers, Acquisitions, Sales & Brokerage Simplification Act of 2017 The bill alleviates costs to small-business owners by simplifying the securities registration system for mergers and acquisition brokers who help transfer the ownership of small, privately held companies. It also disqualifies bad actors from utilizing the simplified process and does not allow transactions involving shell companies. NSBA supports. H.R. 561 - Small Business Job Protection Act of 2017 This bill amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act, to redefine "applicable large employer," for purposes of the mandate requiring employers to provide health insurance for their employees, to mean an employer with at least 100 full-time employees (currently, 50). NSBA supports. H.R. 631 - Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill provides for an inflation adjustment to such exemption amount. NSBA supports. H.R. 1105 - Stop WOTUS Act To repeal the rule entitled "Clean Water Rule: Definition of 'Waters of the United States. NSBA supports H.R.1180 - Working Families Flexibility Act of 2017 This bill amends the Fair Labor Standards Act of 1938 to authorize employers to provide compensatory time off to private employees at a rate of not less than 1 1/2 hours for each hour of employment for which overtime compensation is required, but only if it is in accordance with an applicable collective bargaining agreement or, in the absence of such an agreement, an agreement between the employer and employee. NSBA supports. H.R. 1314 - Renewable Fuel Standard Repeal Act The bill would remove the renewable fuel standard. NSBA is monitoring. H.R. 1339 - Freedom from Government Competition Act Legislation that would require federal agencies to rely on the private sector when providing goods and services that are readily available. NSBA supports. H.R. 1585 - Fair Investment Opportunities for Professional Experts Act It modernizes the definition of accredited investor so those who do not have a high income or high net worth but do have the education and job experience to evaluate investment risks and merits can participate in the growth of promising companies. NSBA supports. H.R. 1680 - Womens Business Centers Improvements Act The bill revises the duties of the Office of Women's Business Ownership and declares it is the Office's mission to assist women entrepreneurs to start, grow, and compete in global markets by providing quality support with access to capital, access to markets, job creation, growth, and counseling. NSBA supports. H.R. 1702 - Small Business Development Centers Improvement Act This bill amends the Small Business Act with respect to the authority of the Small Business Administration (SBA) to use certain SBA programs, including the small business development center (SBDC) program, to provide grants, financial assistance, loans, export assistance, and subcontracting opportunities on federal contracts to specified small businesses, organizations, state governments, universities, companies, and other entities that assist smaller enterprises. NSBA supports. H.R. 1773 - The Clarity for Americas Small Contractors Act of 2017 Amends the Small Business Act to improve reporting on small business goals, achieve uniformity in procurement terminology, clarify the role of small business advocates, and for other purposes. NSBA supports. H.R. 1774 - The Developing the Next Generation of Small Business Act of 2017 Amends the Small Business Act to provide for improvements to small business development centers, the women's business center program, the SCORE program, and for other purposes. NSBA supports. H.R. 2364 - The Investing in Main Street Act H.R. 2364 increases the amount of capital and surplus that a financial institution and federal savings association can invest in a SBIC from 5 percent to 15 percent in order to assist small businesses in obtaining venture capital and private equity. NSBA supports. H.R. 3170 - Small Business Development Center Cyber Training Act This bill amends the Small Business Act to require the Small Business Administration to establish a program for certifying employees of small business development centers to provide cybersecurity planning assistance to small businesses. NSBA supports. H.R. 3717 - the Small Business Owners Tax Simplification Act H.R 3717 introduces a number of provisions to benefit small businesses, such as aligning estimated payment deadlines and tax filing thresholds, as well as tackling inconsistencies in reporting requirements. NSBA supports. H.R. 3972 - Family Office Technical Correction Act The bill clarifies that family offices and family clients, as defined in section 275.202(a)(11)(G)-1 of title 17, Code of Federal Regulations, are accredited investors under Regulation D of the Securities and Exchange Commission. NSBA supports. H.R. 3798 -- Save American Workers Act It delays the ACAs employer mandate, further postpones the so-called Cadillac tax on high-cost health plans and changes the definition of a full-time worker to someone employed 40 hours a week, up from 30 hours. In a win for the sun-tanning lobby, it would repeal ACAs 10 percent tax on indoor tanning salons. NSBA supports. H.R. 4111 - Spurring Business in Communities Act This bill amends the Small Business Investment Act of 1958 to: require the Small Business Administration (SBA), in reviewing and processing a small business investment company's (SBIC's) application, to give first priority to an SBIC applicant located in an underlicensed state (i.e., a state in which the number of licensees per capita is less than the median number of licensees per capita for all states) with below median financing; and exempt applicants in underlicensed states from certain SBA capital requirements. NSBA supports. H.R. 4616 - Employer Relief Act of 2018 It provide for a temporary moratorium on the employer mandate until Jan. 1, 2019 and delay for one year- until after Dec. 31, 2020-the implementation of the Cadillac Tax. NSBA supports. H.R. 4754 - Change Order Transparency for Federal Contractors Act Amend the Small Business Act to provide prospective construction contractors with information about an agency's policies on the administration of change orders to allow such contractors to make informed business decisions regarding the pricing of bids or proposals, and for other purposes. NSBA supports. H.R. 4886 - Permanent Tax Cuts for Americans Act This bill makes permanent the provisions of subtitle A (Individual Tax Reform) and subtitle B (Alternative Minimum Tax) of P.L. 115-97 (commonly known as the Tax Cuts and Jobs Act) that are currently scheduled to terminate on December 31, 2025. NSBA supports. H.R. 5236 - Main Street Employee Ownership Act Expands opportunities available to employee-owned business concerns through Small Business Administration loan programs, and for other purposes. NSBA supports. H.R. 5340 - Support Technology & Research for Our Nations Growth and Economic Resilience (STRONGER) Patents Act The STRONGER Patents Act would restore patents as property rights, make standards of protections in courts uniform, and protect start-ups from being out-resourced by technology incumbents. NSBA supports. H.R. 5515 -John S. McCain National Defense Authorization Act for Fiscal Year 2019 The bill authorizes FY2019 appropriations and sets forth policies for Department of Defense (DOD) programs and activities, including military personnel strengths. NSBA supports the small business contracting provisions. H.R. 5660 - The Small Business Credit Card Act The measure provides small-business owners the same consumer protections as individual credit card holders, by protecting small-business owners credit cards from unfair and deceptive practices of credit card companies. NSBA supports. H.R. 5728 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. H.R. 6199 -- Restoring Access to Medication Act of 2018 This bill repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that limit payments for medications from health savings accounts, medical savings accounts, health flexible spending arrangements, and health reimbursement arrangements to only prescription drugs or insulin (thus allowing distributions from such accounts for over-the-counter drugs). The bill also allows the accounts to be used for menstrual care products. NSBA supports. H.R. 6264 - Restoring Americas Leadership in Innovation Act Bill offers various reforms and other improvements to the current U.S. patent system and helps to reverse prior bills discouraging innovation in the U.S. by weakening patents. NSBA supports. H.R. 6301 - Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act of 2018 It expands access and enhances the utility of HSAs by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible. NSBA supports. H.R. 6305 - Bipartisan HSA Improvement Act of 2018 The bill would allow eligible individuals to make HSA contributions if a spouse has a flexible spending account and permit flexible spending accounts and health reimbursement account terminations or conversions to fund HSAs. NSBA supports. H.R. 6306 - Health Care Security Act of 2018 It expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA. NSBA supports. H.R. 6311 - The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act The bill expands access and use of Health Savings Accounts (HSAs) and lowers premiums on health care plans. NSBA supports. H.R. 6314 - Health Savings Act of 2018 H.R. 6314 expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions. NSBA supports. H.R. 6316 - Small Business Advocacy Improvements Act of 2018 H.R. 6316 allows the SBA Office of Advocacy to examine the role of small business in international economies and to represent small business views before foreign governments and international entities. NSBA supports. H.R. 6321 - Investment Adviser Regulatory Flexibility Improvement Act The legislation directs the SEC to consider alternative methods for businesses or organizations to qualify as a small business or small organization for the purposes of assessing the regulatory impact on investment advisors. NSBA supports. H.R. 6330 - Small Business Runway Extension Act of 2018 H.R. 6330 modifies SBAs size calculation to provide small businesses with more time to be considered small for the purposes of SBAs small business programs. NSBA supports. H.R. 6347 - 7 (a) Real Estate Harmonization Act H.R. 6347 updates SBAs 7(a) Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6348 - Small Business Access to Capital and Efficiency (ACE) Act H.R. 6348 reduces burdens and conflicting regulations for small businesses by updating the Small Business Administrations 504/Certified Development Company Loan Programs commercial real estate appraisal threshold. NSBA supports. H.R. 6367 - Incentivizing Fairness in Subcontracting H.R. 6367 allows large prime contractors to take credit for subcontracting to small businesses at lower tiers, provided that prime contractors keep records substantiating subcontracting credit claimed at lower tiers, and creates a new dispute process for small subcontractors to bring nonpayment issues to the agencys small business advocate (Offices of Small and Disadvantaged Business Utilization). NSBA supports. H.R. 6368 - Encouraging Small Business Innovators Act H.R. 6368 makes a series of changes to the Small Business Innovation Research and Small Business Technology Transfer programs, making them easier for small firms to use. NSBA supports. H.R. 6369 - Expanding Contracting Opportunities for Small Businesses Act of 2018 H.R. 6369 increases the size of sole source contract awards for women owned, service-disabled veteran-owned, HUBZone, and socially and economically disadvantaged small businesses, and implements a new eligibility determination process to ensure sole source awards are made to eligible firms. NSBA supports. H.R. 6382 -Clarity on Small Business Participation in Category Management Act of 2018 H.R. 6382 requires the SBA to report federal spending made through designated best-in-class vehicles, and to report on the dollars spent through these vehicles awarded to small businesses. NSBA supports. H.R. 6446 - White House Conference on Small Business Act of 2018 It reauthorizes, and amends, the White House Conference on Small Business Authorization Act from the early 1990s, which is Public Law 101-409. The bill requires the state conferences, regional conferences and the National Conference to occur no earlier than December 31, 2018 and no later than December 1, 2019. NSBA supports. H.R. 6695 -The Trademark Licensing Protection Act of 2018 The bill clarifies that licensing trademarks, and controlling or exercising those trademarks, do not create an employment relationship. NSBA is monitoring. H.R. 6757 - The Family Savings Act of 2018 It includes a variety of provisions aimed at making it easier for smaller businesses to offer tax-qualified retirement savings plans to their employees, encouraging individuals to participate in retirement plans, and promoting savings for nonretirement expenses. NSBA is monitoring. H.R. 6756 - The American Innovation Act of 2018 It includes two provisions intended to boost innovation by allowing new businesses to write off larger amounts of their costs up front as well as allowing a corporation that buys a start-up to retain some of the acquired entitys net operating losses or other tax attributes, like research and development tax credits. NSBA supports. H.R. 6760 - the Protecting Family and Small Business Tax Cuts Act of 2018 Bill would make permanent provisions from the 2017 tax law such as the lower individual income tax rates, the higher standard deduction, the increased and modified child tax credit, the increased exemption and phase-out threshold for the individual alternative minimum tax, the increased estate and gift tax exemption, and the 20 percent deduction for certain passthrough income, all of which are currently set to expire after 2025. NSBA supports. S. 18 - the Fair Tax Act To promote freedom, fairness, and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. NSBA supports S. 21 - Regulations from the Executive in Need of Scrutiny (REINS) Act The REINS Act seeks to restore authority to Congress by allowing lawmakers to have final say on regulations with an estimated economic impact of more than $100 million. NSBA supports. S. 34 - Midnight Rule Relief Act The bill would prevent agencies from proposing or finalizing regulations from the day after elections to the day of the next presidential inauguration. NSBA supports S. 205 -- Death Tax Repeal Act of 2017 This bill amends the Internal Revenue Code to: (1) repeal the estate and generation-skipping transfer taxes, and (2) make permanent the maximum 35% gift tax rate and the lifetime gift tax exemption. The bill also provides for an inflation adjustment to such exemption amount. NSBA supports. S. 584 - The Small Business Regulatory Flexibility Improvements Act To require federal agencies to analyze the full impact of a proposed regulation on small businesses during the rulemaking process. NSBA supports. S.770 - NIST Small Business Cybersecurity Act To require the Director of the National Institute of Standards and Technology to disseminate resources to help reduce small business cybersecurity risks, and for other purposes. NSBA supports. S.791 - Small Business Innovation Protection Act of 2017 To amend the Small Business Act to expand intellectual property education and training for small businesses, and for other purposes. NSBA supports. S. 951 - the Regulatory Accountability Act (RAA) This bill codifies and revises notice-and-comment rulemaking procedures to require federal agencies to consider: (1) whether a rulemaking is required by statute or is within the discretion of the agency, (2) whether existing federal laws or rules could be amended or rescinded to address the problem, and (3) reasonable alternatives for a new rule. NSBA supports. S.1390 - STRONGER Patents Act of 2017 The STRONGER Patents Act takes critical steps to improve the patent system. It treats patents like any other property, permitting injunctions to protect patent owners against infringement during and after court cases. It ensures fairness in Patent Office administrative proceedings, limiting repetitive and harassing challenges against inventors and it ends the diversion of patent application fees to other government spending, ensuring the Patent Office has the funding needed to grant high-quality patents without harmful delay. NSBA supports. S.2108 - The Miscellaneous Tariff Bill Act of 2017 Trims the duties on more than 1,800 imports deemed to not pose a competitive threat to U.S. producers. NSBA supports. S.2283 - The Small Business 7(a) Lending Oversight Reform Act of 2018 Amends the Small Business Act to strengthen the Office of Credit Risk Management within the Small Business Administration, and for other purposes. NSBA supports. S.2708 - Choose Medicare Act Bill creates a Medicare health plan for all ages that would be offered in state and federal health exchanges, as well as the employer-sponsored market. NSBA is monitoring. S. 2800 - Americas Water Infrastructure Act of 2018 A bill to provide for the conservation and development of water and related resources, to authorize the Secretary of the Army to construct various projects for improvements to rivers and harbors of the United States, and for other purposes. NSBA supports. S. 2810 - The Workplace Democracy Act The bill narrows who can lawfully be classified an independent contractor, nullify state right-to-work laws, and allow workers to vote in a union campaign through the informal method of card check instead of a secret-ballot vote. NSBA opposes. S. 3345 - Economic Security for New Parents Act Bill allows those who choose to withdraw from their Social Security benefits early will be able to get at least two months of leave after the arrival of a child by birth or adoption. NSBA is monitoring.

Client expense: $27,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Export-Import Bank of the United States (EXIM Bank), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Intl Trade Administration (ITA), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Office of Personnel Management (OPM), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 4616, "Employer Relief Act of 2018". Monitor cadillac tax delay.

Client expense: $600,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

H.R. 1 - Tax Cuts and Jobs Act (Reduces ACA individual mandate penalty.) H.R. 6 - Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (Employer-sponsored plan Medicare secondary payer rules.) H.R. 1313 - The Preserving Employee Wellness Programs Act (Clarification of wellness programs.) H.R. 3798 - Save American Workers Act (Amends the ACA definition of full-time.) H.R. 5138 - Bipartisan HSA Improvement Act of 2018 (Expands the use of Health Savings Accounts.) H.R. 6128- HSA Employer Flexibility Act (Expansion of HSAs to include on-site employee clinics, retail clinics & telehealth services.) H.J. Res 125 The Extension of Continuing Appropriations Act (Delayed the Cadillac Tax until 2022.) H.R. 6301 - Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Expands the use of Health Savings Accounts.) H.R. 6305 - Bipartisan HSA Improvement Act (Expands the use of Health Savings Accounts.) H.R.6199 - Restoring Access to Medication Act (Expands the use of Flexible Spending Arrangements and Health Savings Accounts.) H.R. 6312- Personal Health Investment Today (PHIT) Act (Expands the use of Health Savings Accounts.) H.R. 4616 - Employer Relief Act (Repeals employer mandate penalty.) H.R. 6311 - Premium Plans and Expanding Health Savings Accounts Act (Expands the use of Health Savings Accounts.) H.R. 173 and S. 58 - The Middle-Class Health Benefits Tax Repeal Act (Repeals the health care excise tax.) H.R. 3919 and S. 1908 - Commonsense Reporting Act (Clarifies the ACA employer reporting requirements.) H.R. 4978 / S. 2410 - Chronic Disease Management Act of 2018 (Expands HSA to provide care for chronic conditions with no deductible.) S. 1782 - Forty Hours is Full-Time Act (Amends the ACA definition of full-time.) Association Health Plans (DOL) Health Care Reform - White House

Client expense: $723,049 · Firm income: Not reported

Government targets: Equal Employment Opportunity Commission (EEOC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), SENATE, Small Business Administration (SBA), White House Office

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), H.R. 6, the SUPPORT for Patients and Communities Act and S. 2680, the Opioid Crisis Response Act of 2018. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans.

Client expense: $1,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR), White House Office

H.R. 4616, A bill to amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage - Cadillac Tax and Employer Mandate Moratorium

Client expense: $420,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of, U.S. Trade Representative (USTR)

Insurance market policies (Bipartisan Health Care Stabilization Act; Short-term, Limited Duration Health Insurance rule; Association Health Plans rule) Risk adjustment payments Cost sharing reduction payments Insurance navigator funding 340B Drug Pricing Program (H.R. 4392; H.R. 4710, 340B PAUSE Act; S. 2453, Ensuring the Value of the 340B Program Act; H.R. 6071, Stretching Entity Resources for Vulnerable Communities Act; H.R. 2889, Closing Loopholes for Orphan Drugs Act; H.R. 5598, 340B Optimization Act; H.R. 6240, Drug Discount Accountability Act; H.R. 6273, Creating Access to Rape Kit Exams (CARE) for Survivors Act) Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) IV and medication shortages Drug prices (American Patients First, Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs; S. 2554 / H.R. 6143, Patient Right to Know Drug Prices Act; S. 2553, Know the Lowest Price Act; H.R. 6733, Know the Cost Act) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Consumer Directed Health Plans Legislation (H.R. 6311 would modify the definition of a qualified health plan and allow individuals purchasing health insurance in the individual market to purchase a "copper" plan or use the premium tax credit to buy off-marketplace coverage; H.R. 6301 to allow CDHPs to provide coverage for services like telehealth, chronic disease management, or primary care visits below the minimum deductible; H.R. 6317 to allow coverage of direct primary care service arrangements; H.R. 6305 to permit use of CDHPs to receive certain employment-related health services like onsite clinics; H.R. 6309 to allow individuals only enrolled in Medicare Part A to contribute to health savings accounts; H.R. 6199 to include certain over-the-counter medical products as qualified medical expenses; H.R. 6306 to increase the current contribution limits for HSAs; H.R. 6312, Personal Health Investment Today (PHIT) Act to count sports equipment and exercise costs toward medical expenses; H.R. 6313 to allow carry-forward of flexible spending account balances each year; H.R. 6314 to allow bronze and catastrophic plans in connection with health savings accounts, allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions) H.R. 4616 to delay the implementation of the excise tax on high cost employer-sponsored health coverage; and place a moratorium on the employer mandate Liver allocation policy

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 3798, Save American Workers Act (Walorski) - delay in Cadillac tax H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) - OTC medical products as qualified medical expense, HSA improvements H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility; treatment of certain employment-related services; FSA and HRA conversions H.R. 6306, Health Care Security Act (Paulsen) - HSA contribution limits, spousal catch-up contributions, grace period for medical expenses H.R. 6309, Allowing Working Seniors to Keep Their Health Savings Accounts Act (Paulsen) - HSA contributions by Medicare-eligible individuals H.R. 6311, Increasing Access to Lower Premium Plans and Expanding HSAs Act (Roskam) - suspension of health insurance tax, HSA improvements H.R. 6312, Personal Health Investment Today Act (Smith) - medical care tax deduction for qualified sports and fitness expenses H.R. 6313, RAISE Health Benefits Act (Stivers) - Health FSA rollovers H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan H.R. 6317, Primary Care Enhancement Act (Paulsen) - participation by HSA-eligible individuals in direct primary care (DPC) arrangements Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to enhancing tax treatment of long-term care insurance; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

S. 28, Health Savings Account Expansion Act (Flake) - HSA improvements S. 85, Restoring Access to Medications Act (Roberts) - paying for OTC products with HSA funds S. 403, Health Savings Act (Hatch) - HSA and FSA improvements S. 761, Health Care Options Act (Alexander) - using premiums for off-Exchange plans S. 1859, Healthcare Tax Relief Act (Gardner) - suspension of ACA health insurance tax S. 1978, Small Business and Family Health Tax Relief Act (Heitkamp) - suspension of ACA health insurance tax S. 2410, Chronic Disease Management Act (Thune) - flexibility for high-deductible health plans S. 3063, Health Insurance Tax Relief Act (Barrasso) - suspension of ACA health insurance tax H.R. 195, Extension of Continuing Appropriations Act - one-year suspension of ACA health insurance tax, two-year delay in ACA excise tax on employer-sponsored health plans H.R. 246, Jobs and Premium Protection Act (Noem-Sinema) - repeal of ACA health insurance tax H.R. 247, Health Savings Account Expansion Act (Brat) - HSA improvements H.R. 394, Restoring Access to Medications Act (Jenkins) - paying for OTC products with HSA funds H.R. 1175, Health Savings Act (Paulsen) - HSA and FSA improvements H.R. 4616 (Nunes) - delay in ACA excise tax on employer-provided health coverage H.R. 4618 (Jenkins) - use of HSA funds for OTC medications H.R. 4620, Protecting Families and Small Businesses Act (Noem) - relief from ACA health insurance tax H.R. 4894, Harmful Tax Prevention Act (Noem) - relief from ACA health insurance tax H.R. 4978, Chronic Disease Management Act (Black) - flexibility for high-deductible health plans H.R. 5138, Bipartisan HSA Improvement Act (Kelly) - HSA changes H.R. 5963, Health Insurance Premium Reduction Act (Noem) - suspension of ACA health insurance tax H.R. 6199, Restoring Access to Medication Act (Jenkins) -- OTC medical products as qualified medical expense H.R. 6301, Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act (Roskam) - flexibility on first dollar coverage for HSA plans H.R. 6305, Bipartisan HSA Improvement Act (Kelly) - HSA flexibility H.R. 6314, Health Savings Act (Burgess) - definition of high-deductible health plan Regulatory Issues: Annual insurer provider fees; issues concerning the patient-centered outcomes research fee; employer and individual coverage mandate; W-2 reporting requirements; health reimbursement accounts; deductibility limits for insurer compensation; health insurer and employer reporting of health coverage; issues related to implementation of health insurance tax; issues related to the refundable credit for coverage under a qualified health plan; issues related to coverage of chronic conditions in high deductible health plans; issues related to health savings accounts; issues related to the deductibility of employer-sponsored health coverage; issues related to qualified small employer health reimbursement accounts (QSEHRAs); issues related to implementation of the excise tax on high cost employer-sponsored health coverage; and other issues relating to health care reform implementation.

Client expense: $1,410,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 4616, the Employer Relief Act of 2018 H.R. 1038/S. 413 - Improving Transparency and Accuracy in Medicare Part D Spending Act H.R.592/S. 109 - Pharmacy and Medically Underserved Areas Enhancement Act H.R. 1313 - The Preserving Employee Wellness Programs Act H.R. 3919/S. 1908 - Commonsense Reporting Act of 2017 H.R. 3798 - Save American Workers Act of 2017 H.R. 6199 - To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses HIT delay

Client expense: $180,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act, and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms, non-discrimination provisions, the high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, regarding a one-year delay of the Cadillac Tax, H.R. 4620, regarding relief from the Health Insurance Tax, Substance use disorders, and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act), and H.R. 6, the SUPPORT for Patients and Communities Act. Issues related to proposed changes to the definition of Employer Under Section 3(5) of ERISA for Association Health Plans.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-H.R. 173/S.58: Middle Class Health Benefits Tax Repeal Act of 2017 -Cap on tax exclusion for employer-based health insurance -prescription drugs-Affordability -H.R. 6: SUPPORT for Patients and Communities Act (expanded funding for opioid treatment and prevention): Workplace advisory committee -S. 3120: HEAL Act of 2018 (provisions related to expanded funding for opioid treatment and prevention) -H.R. 6199: Restoring Access to Medication & Modernizing Health Savings Accounts Act of 2018 -Legislative proposal to repeal major portions of the ACA & implement state block grants -H.R. 3748: Medicare buy-in and Health Care Stabilization Act of 2017: Employment based health plans -H.R. 6505: Medicare Negotiation & Competitive Licensing Act of 2018: prescription drug prices -NAFTA: patents, i.e. prescription drug prices -Pension benefit guaranty corporation Premiums -H.R. 184: Protect Medical Innovation Act of 2018: provisions related to expanding funding for opioid treatment & prevention services -H.R. 5788/S. 3057: STOP Act: Provisions related to civil penalties levied against postal service; advance electronic data requirements -H.R. 4616: Employer Relief Act -H.R. 6311: Increasing access to lower premium plans & expanding health savings accounts act of 2018 -H.R. 3798: Save American Workers Act of 2017: Provisions related to modifying the ACA shared responsibility requirements

Client expense: $520,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), U.S. Trade Representative (USTR)

Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, , including exchanges, cost sharing reduction, market reforms, and non-discrimination provisions. The high cost employer health insurance excise tax, including H.R. 173 and S. 58, the Middle Class Health Benefits Tax Repeal Act of 2017, and H.R. 4616, the Employer Relief Act of 2018, regarding a one-year delay of the Cadillac Tax. H.R. 4620, the Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. Substance use disorders and 42 CFR Part 2 - Confidentiality of Substance Use Disorder Patient Records, specifically H.R. 3545, H.R. 5795, and H.R.6082, the Overdose Prevention and Patient Safety Act (OPPS Act) and H.R. 6, the SUPPORT for Patients and Communities Act.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4575/S.2303, the Access to Independent Health Insurance Advisors Act; H.R. 173/S. 58 the Middle Class Americans' Health Plans Act; H.R. 372, the Competitive Health Insurance Reform Act of 2017; H.R. 1628, American Health Care Act of 2017; Issues related to the Federally-facilitated marketplaces;S. 191, the Patient Freedom Act of 2017; H.R. 1626, the Better Care Reconciliation Act of 2017; H.R. 3798, the Save American Workers Act of 2018; H.R.4616, the Employer Relief Act of 2018; Comments on the Cooperative Agreement to Support Navigators in Federally Facilitated Exchanges, Funding Opportunity Number: CA-NAV-18-001

Client expense: $87,356 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Risk Management Agency, SENATE, Treasury, Dept of

H.R 4894, The Harmful Tax Prevention Act. Monitored the implementation of The Tax Cut and Jobs Act, P.L. 115-97, as it relates to corporate tax issues, the taxation of multinational corporations and life insurance; S.58 / H.R. 173, Middle Class Health Benefits Tax Repeal Act of 2017. H.R. 4620, Protecting Families and Small Businesses Act of 2017, regarding relief from the Health Insurance Tax. H.R. 4616, the Employer Relief Act, regarding a one-year delay of the Cadillac tax.

Client expense: Not reported · Firm income: $60,750

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Health care reform and tax reform issues related to the taxation of employer-provided health benefits, including the 40% tax on health benefits. Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 H.R. 4616, a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Health care reform and tax reform issues related to the taxation of employer-provided health benefits, including the 40% tax on health benefits. Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 H.R. 4616, a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Legislative and regulatory issues including: Health care reform Implementation of the Affordable Care Act -- PL 111-148 Bipartisan Budget Act of 2018 -- H.R. 1892/PL 115-123 Middle Class Health Benefits Tax Repeal Act of 2017 - S. 58/H.R. 173 Save American Workers Act -- H.R. 3798 Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) Health Savings Act of 2017 - S. 403/H.R. 1175 Chronic Disease Management Act - S. 2410/H.R. 4978 Bipartisan HSA Improvement Act of 2018 - H.R. 5138/H.R. 6305 Mental Health Parity H.R. 6301, to provide high deductible health plans with first dollar coverage flexibility H.R. 6317, to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions H.R. 6309, to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts H.R. 6306, to increase the contribution limitation for health savings accounts, and for other purposes H.R. 4616, to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act S. 2554, the Patient Right to Know Drug Prices Act S. 2553, the Know the Lowest Price Act HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs, RIN 0991-ZA49

Client expense: Not reported · Firm income: $30,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of